Imaging assessment after SBRT for hepatocellular carcinoma

Yip, Connie; Hennedige, Tiffany; Cook, Gary; Goh, Vicky

doi:10.20517/2394-5079.2020.30

Cited by 5 publications

(5 citation statements)

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“…Six cases of radiation-induced TLS in solid tumor malignancies have previously been described. 24 , 25 , 26 , 27 , 28 , 29 The details of these cases are summarized in Table 2 . All patients received radiation alone.…”

Section: Discussionmentioning

confidence: 99%

Tumor Lysis Syndrome in a Patient With Metastatic Endometrial Cancer Treated With Lattice Stereotactic Body Radiation Therapy

Schiff¹,

Spraker²,

Duriseti³

et al. 2022

Advances in Radiation Oncology

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Section: Discussionmentioning

confidence: 99%

Tumor Lysis Syndrome in a Patient With Metastatic Endometrial Cancer Treated With Lattice Stereotactic Body Radiation Therapy

Schiff¹,

Spraker²,

Duriseti³

et al. 2022

Advances in Radiation Oncology

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“…From this perspective, if the two lesions are close to each other, the first treatment operation (especially if the SBRT is carried out first) may change the location, shape, and texture of the lesions, thus increasing the difficulty of the later treatment. High doses of radiation stimulation from SBRT treatment cause some degree of reactive hyperemia, hepatic cell loss, hyperplasia, or parenchymal fibrosis [ 33 ]. However, unexpectedly, our novel RFA and SBRT treatment exhibited no adverse grade 3+ events.…”

Section: Discussionmentioning

confidence: 99%

“…The adverse effects were comparable with or even lower than those of using RFA or SBRT alone (reported adverse events of grade 3+ for RFA or SBRT treatment alone are 2.6–11% and 1.6–5%, respectively [ 12 , 18 , 20 ]). Radiological examinations were performed every three months in the first year of follow-up, every three to six months in the second year, and every 6 − 12 months in the subsequent years depending on the clinical needs [ 33 ]. Notably, because of reactive hyperemia by high-dose radiation stimulation, AP hyperenhancement can occur after SBRT in successfully treated HCCs and may not represent a viable residual tumor.…”

Section: Discussionmentioning

confidence: 99%

Optimal application of stereotactic body radiotherapy and radiofrequency ablation treatment for different multifocal hepatocellular carcinoma lesions in patients with Barcelona Clinic Liver Cancer stage A4–B1: a pilot study

et al. 2021

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Background In clinical practice, many hepatocellular carcinoma (HCC) patients in Barcelona Clinical Liver Cancer (BCLC) stage A4–B1 cannot receive the curative treatments of liver transplantation, resection, and radiofrequency ablation (RFA), which are the recommended options according to liver cancer guidelines. Our aim is to study the feasibility of RFA and stereotactic body radiotherapy (SBRT) as a curative treatment for different multifocal HCCs in BCLC stage A4–B1 patients. Methods From September 2014 to August 2019, 39 multifocal HCC lesions (median diameter: 16.6 mm) from 15 patients (median age: 73 years) were retrospectively selected. Among them, 23 were treated by RFA and the other 16 by SBRT because of predictable insufficiency and/or risk related to RFA performance. The indicators for evaluating this novel therapy were the tumor response, prognosis (recurrence and survival), and adverse effects (deterioration of laboratory test values and severe complications). Results The median follow-up duration was 31.3 months (range: 15.1–71.9 months). The total patients with a one-year complete response, stable disease, or disease progression were 11, 1, and 3, respectively. In total, 8 and 2 patients had confronted intrahepatic or local recurrence, respectively. The one-year progression-free survival rate and local control rate were 80% (12/15 patients) and 97.4% (38/39 lesions), respectively. The median time to progression was 20.1 (2.8–45.1) months. The one- and two-year survival rates were 100 and 88.9%, respectively. In up to five months’ observation, no patient showed severe complications. Seven, four, and two patients had slight changes in their white blood cells, platelet count, or albumin–bilirubin grade, respectively. Conclusions For patients with BCLC stage A4–B1, RFA and SBRT treatment for different multifocal HCCs may be a potential option because of the favorable prognosis and safety. However, before its application in clinical practice, prospective, controlled, large-scale studies are needed to further confirm our conclusions.

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“…Radiological examinations were performed every three months in the rst year of follow-up, every 3-6 months in the second year, and every 6-12 months in the subsequent years depending on the clinical needs [30]. Notably, because of reactive hyperemia by high-dose radiation stimulation, AP hyperenhancement can occur after SBRT in successfully treated HCCs and may not represent residual viable tumor.…”

Section: Discussionmentioning

confidence: 99%

Optimal Application of Stereotactic Body Radiotherapy and Radiofrequency Ablation Treatment for Different Multifocal Hepatocellular Carcinoma Lesions in Patients With Barcelona Clinic Liver Cancer Stage A4–B1: A Pilot Study

Wang

Numata

Takeda

et al. 2020

Preprint

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BackgroundsIn clinical practice, many hepatocellular carcinoma (HCC) patients in Barcelona Clinical Liver Cancer (BCLC) stage A4–B1 can not receive curative treatment of liver transplantation, resection and RFA which were recommended options by liver cancer guidelines. Our aim is to study the feasibility of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) as curative treatment for different multifocal HCCs in BLCL stage A4–B1 patients. MethodsFrom September 2014 to August 2019, 39 multifocal HCC lesions (median diameter, 16.6 mm) from 15 patients (median age, 73.2 years) were retrospectively enrolled. Among them, 23 were treated by RFA and the other 16 by SBRT because of predictable insufficiency and/or risk for RFA performance. The indicators for evaluating this novel therapy were tumor response, prognosis (recurrence and survivals), and adverse effect (deteriorated laboratory test values and severe complications). ResultsMedian follow-up duration was 31.3 months (range: 15.1–71.9 months). The numbers of one-year complete response, stable disease, and disease progression were 11, 1, and 3, respectively. In total, eight and two patients had confronted intrahepatic and local recurrence, respectively. The one-year progression-free survival rate and local control rate were 80% (12/15 patients) and 97.4% (38/39 lesions), respectively. Median time to progression was 20.1 (2.8–45.1) months. The one- and two-year survival rates were 100%, and 88.9%, respectively. During one week to 3–5 months’ observation, no patient showed severe complications. Seven, four, and two patients had slight changes in white blood cells, platelet count, and albumin–bilirubin grade, respectively. ConclusionsFor patients with BCLC stage A4–B1, RFA and SBRT treatment for different multifocal HCCs may be a potential option because of their favorable prognosis and safety. However, before setting assured application in clinical practice, prospective, controlled, large-scale studies are needed to further confirm our conclusions.

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Imaging assessment after SBRT for hepatocellular carcinoma

Cited by 5 publications

References 0 publications

Tumor Lysis Syndrome in a Patient With Metastatic Endometrial Cancer Treated With Lattice Stereotactic Body Radiation Therapy

Tumor Lysis Syndrome in a Patient With Metastatic Endometrial Cancer Treated With Lattice Stereotactic Body Radiation Therapy

Optimal application of stereotactic body radiotherapy and radiofrequency ablation treatment for different multifocal hepatocellular carcinoma lesions in patients with Barcelona Clinic Liver Cancer stage A4–B1: a pilot study

Optimal Application of Stereotactic Body Radiotherapy and Radiofrequency Ablation Treatment for Different Multifocal Hepatocellular Carcinoma Lesions in Patients With Barcelona Clinic Liver Cancer Stage A4–B1: A Pilot Study

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